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Table 3 Appraisal of included studies

From: Does performance-based financing increase value for money in low- and middle- income countries? A systematic review

Author (year) Was a clear relation between costs & consequences established? Which alternative intervention was considered? The costs (or inputs) and consequences were measured over which time frame? Were important costs (or inputs) and consequences omitted? What were the main limitations? Are there potential conflicts of interest?
Bowser (2013) [19] No Status quo (traditional salaries and line-item budgets). 2006 to 2010 No clear description of the included and omitted costs. 1) absence of pre-intervention data; 2) possibility that other factors influenced the costs per capita; 3) difficulty of teasing apart the effects due to the incentives from those related to other components of the reform. - None declared
- 1 author affiliated with the organisation involved in the implementation
Gok (2015) [18] No Status quo (before vs after P4P). 2001-2008 Yes, for example, the costs of implementing the program were not included. 1) the absence of randomization; 2) the lack of a control group; and 3) the use of aggregate input and output variables. - None declared
Zeng (2013) [21] No International support (including procurement procedures, minor renovations, advice on community mobilization, communication, public relations & promotion of family planning). 2008-2010 No clear description of the included and omitted costs for the "international support". 1) absence of randomization; 2) the absence of pre-intervention data; 3) the lack of control for the quality of the data in the 202 health centers without PBF. - Declaration that one co-author was employed by an organisation involved in PBF.
Basinga (2011) [16] No Input-based budgets in the control group were increased by the average P4P payments made to the intervention group June, 2006 to Avril 2008 (~23 months) Lack of detailed information on the costs of PBF. Health outcomes were not included. 1) the absence of pre-intervention data; 2) problems identified with allocation to treatment and control-groups (see Witter et al., 2013). - None declared
- Some authors affiliated with organisations involved in the funding and implementation.
Rusa (2009) [22] No Status quo for performance data (3 months of pre-intervention data). No alternative intervention was used to compare costs. 2005 to 2007 for costs. October 2014 to December 2007 for performance. Includes subsidies and administration costs. No detailed description of the included and omitted costs. Health outcomes were not included. 1) insufficient use of pre-intervention data; 2) the lack of a control group without PBF during the entire time period; and 3) the possibility that other interventions (e.g., mutual health organizations, sensitization campaigns) influenced the results. - None declared
- 5 of 6 authors affiliated with organisations involved in the implementation
Sabri (2007) [20] No Comparison of three different PBF programs. 2002 to 2006 No clear description of the included and omitted costs. Limited data on healthcare services and health outcomes. 1) the lack of information on the methodology used; and 2) the absence of links between the costs and outcomes. - None declared
- At least one author employed by an organisation involved in the implementation
Soeters (2006) [23] No Comparison of PBF in early vs later stages. 2003 to 2005 Lack information on how PBF affects total health expenditures (only focuses on out-of-pocket health spending). 1) absence of pre-intervention data; 2) absence of a control group; and 3) possibility that other interventions occurring simultaneously reduced catastrophic user fee payments. - None declared
- Authors worked for an organisation involved in the implementation